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Personal, Address, Phone, and Passport Information: Do Not Bring This To Your Interview

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6/20/23, 6:07 PM Non-Immigrant Visa - Review Personal, Address, Phone, and Passport Information

Online Nonimmigrant Visa Application (DS-160) Application ID AA00C15JA3

Personal, Address, Phone, and Passport Information


Note: You have completed data entry for your NIV application. Before submitting the application, please review your entries below. To
navigate to the next section to be reviewed, click the ‘Next’ button on the bottom of the page. If an entry is incorrect, click on the links on
the right side of the page, which will direct you to the page where you entered the data. Once you have reviewed all sections, you will be
directed to the Sign and Submit page to complete the application process.
Photo Provided: Upload New Photo

DO NOT BRING THIS TO YOUR INTERVIEW


Edit Personal Information

Name Provided: SANDUKHADZE, RUSLANI

Full Name in Native Alphabet: სანდუხაძე რუსლანი

Other Names Used: NO

Telecode Name Used: NO

Sex: MALE

Marital Status: MARRIED

Date of Birth: 14 OCTOBER 1972

Country/Region of Birth: UKRAINE, UKRAINE

Country/Region of Origin (Nationality): GEORGIA

Do you hold or have you held any nationality other than the one NO
indicated above on nationality?

Are you a permanent resident of a country/region other than your NO


country/region of origin (nationality) above?

National Identification Number: 60002012850

U.S. Social Security Number: DOES NOT APPLY

U.S. Taxpayer ID Number: DOES NOT APPLY

Edit Address and Phone Information

Home Address: 10 BAGRATIONI STR

City: KUTAISI

State/Province: DOES NOT APPLY

Postal Zone/ZIP Code: 4600

Country/Region: GEORGIA

Same Mailing Address? YES

Primary Phone Number: +995577345501

Secondary Phone Number: DOES NOT APPLY

Work Phone Number: DOES NOT APPLY

DO NOT BRING THIS TO YOUR INTERVIEW


https://ceac.state.gov/GenNIV/General/review/review_reviewpersonal.aspx?node=ReviewPersonal 1/2
6/20/23, 6:07 PM Non-Immigrant Visa - Review Personal, Address, Phone, and Passport Information

DO NOT BRING THIS TO YOUR INTERVIEW


Have you used additional phone numbers in the last five years? NO

Email Address: r.sandukhadze@airnav.ge

Have you used additional email addresses in the last five years? YES

Email Address (1): R.SANDUKHADZE@GMAIL.COM

Email Address (2): SANDUKHADZE@MAIL.RU

Do you have a social media presence?

Social Media Provider/Platform (1): FACEBOOK

Social Media Identifier: HTTPS://WWW.FACEBOOK.COM/RUSLAN.SANDUKHADZE

Social Media Provider/Platform (2): INSTAGRAM

Social Media Identifier: HTTPS://WWW.INSTAGRAM.COM/RUSLANSANDUKHADZE/

Social Media Provider/Platform (3): LINKEDIN

Social Media Identifier: HTTPS://WWW.LINKEDIN.COM/IN/RUSLAN-SANDUKHADZE-


49B

Social Media Provider/Platform (4): TWITTER

Social Media Identifier: HTTPS://TWITTER.COM/RSANDUKHADZE

Social Media Provider/Platform (5): YOUTUBE

Social Media Identifier: HTTPS://WWW.YOUTUBE.COM/@RUSLANSANDUKHADZE3937

Have you used additional social media platforms in the last five years? YES

Social Media Provider/Platform (1): OK.RU

Social Media Identifier: HTTPS://OK.RU/RUSLAN.SANDUKHADZE

Edit Passport/Travel Document Information

Passport/Travel Document Type: REGULAR

Passport/Travel Document Number: 17AA36411

Passport Book Number: DOES NOT APPLY

Country/Authority that Issued Passport/Travel Document: GEORGIA

City where issued: TBILISI

Country/Region where issued: GEORGIA

Issuance Date: 17 JANUARY 2018

Expiration Date: 17 JANUARY 2028

Have you ever lost a passport or had one stolen? NO

DO NOT BRING THIS TO YOUR INTERVIEW

https://ceac.state.gov/GenNIV/General/review/review_reviewpersonal.aspx?node=ReviewPersonal 2/2

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